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1 2nd June 00:33
lawrence j. bookbinder
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Posts: 1
Default review of: Invasion of the Prostate Snatchers (cryotherapy bladder hyperplasia cancer ultrasound)


Prostate Snatchers, published in August of 2010, is the best book I
know of to help newly diagnosed men decide what to do about their


brim with gems of cutting-edge, authoritative information. Below are
some of these gems, which, unfortunately, only a small minority of PCa
patients have seen:

There is not one but three basic categories of PCa--Low-Risk,
Intermediate-Risk, and High-Risk.

High-Risk, also known as “aggressive,” should be treated aggressively
whereas Low-Risk often can be safely managed with no treatment.

A typical scenario after a primary care doctor refers a patient to a
urologist because of an abnormal PSA test and/or digital rectal
examination (DRE): The urologist biopsies the patient's prostate and
finds PCa. The patient views this finding as a death sentence, panics,
and feels pressured to get rid of his cancer immediately. He avoids
taking time for second opinions and agrees quickly to have the
urologist cut out his entire prostate (radical prostatectomy or RP)--
an aggressive treatment.

Unfortunately, of the 50,000 RPs done in the USA every year, more than
40,000 were not necessary. That is, the vast majority of PCa patients
would have lived as long without having their prostates removed.

RP is no longer the most effective treatment for PCa. Radiation
therapy (RT), another aggressive treatment, has evolved into being at
least as effective. *If the patient consults a radiation therapist for
help with making a treatment decision, the doctor is often, of course,
biased in favor of recommending RT.

A third type of PCa doctor is a medical oncologist. They are trained
to treat all types of cancer--lung, blood, bladder, pancreas, etc,
Their training in PCa treatment only focuses on advanced disease.
Early-stage disease is left to the urologists.

Medical oncologists treat some PCa patients with testosterone
inactivating pharmaceuticals (TIP, also known as “hormone blockade” or
“androgen deprivation therapy”). *TIP has its own set of side effects
but, unlike RP, RT, or cryotherapy, the side effects are often
reversible when the medical oncologist discontinues the TIP. And he
then, depending on the PCa’s response to the discontinuation, may re-
start the TIP a year or two or three later.

Unfortunately, only a minority of urologists are as skilled as MOSPCs
in providing TIP.

Of the more than 10,000 *medical oncologists in the USA only less
than 100 are MOSPCs.

MOSPCs often do a more comprehensive evaluation of PCa than some
urologists. In addition to PSA tests, DREs, PSA velocity calculations,
and PSA density calculations, they may use spectrographic endorectal
MRI (S-MRI) scans, color doppler ultrasound scans, and PCA-3 urine
tests to determine whether a patient is Low-, Intermediate-, or High-
Risk. These tests also help monitor a patient’s PCa (known as “active
surveillance” or AS).

The comprehensive evaluation helps to determine whether the patient
should have an immediate initial biopsy. If the patient has had a
biopsy, the evaluation may reduce the number of repeat biopsies needed
for AS.

Typically, a MOSPC will offer the Low-Risk patient the option of no
treatment but with AS. If the patient rejects this option because he
wants to kill his PCa, the MOSPC will mention the advantages and
disadvantages of aggressive treatments such as RP, RT, and
cryotherapy, and with less bias than most urologists, radiation
therapists, and cryotherapists, respectively.

Chapters written by Ralph H. Blum, a patient of his co-author, vividly
illustrate the struggles of and benefits received by a patient who
educates himself about PCa, finds the right doctor for him, and avoids
blindly following his and other PCa doctors’ advice. Blum’s knowledge
and story of his 20-year PCa journey is likely to calm many patients,
instill hope, and empower them to play an active role in their
journey.

Blum traveled from the USA to Holland to have a recommended Combidex
MRI because it was the only place in the world that performed the
scan. *My guess is that no more than 10 percent of PCa patients are
able to take the time off and/or pay for out-of-state/country trips
for tests or second opinions. I wish the book would have acknowledged
this unfortunate obstacle to obtaining state-of-the-art help.

Snatchers adds much to the meager literature on the role of the MOSPC
in working with Low-Risk patients and helping patients decide on a
treatment.

The preliminary international list of MOSPCs might help some patients
find the “right doctor.” Also helpful are a glossary, annotated
bibliography, and lists of acronyms and websites.

Snatchers replaces my former #1 choice, A Primer on Prostate Cancer:
The Empowered Patient’s Guide (2nd edition, 2005) by Stephen B. Strum,
M.D. (a distinguished MOSPC) and Donna L. Pogliano. Snatchers is
easier to read and understand; more up-to-date, of course; and
destined to become a classic, which is the status of Primer.

My qualifications for writing this review are 10 years of reading
authoritative PCa literature; participating in PCa internet discussion
forums; leading PCa support group discussions; seeing the MOSPC co-
author of Snatchers every three months for nine years; consulting
other PCa doctors; undergoing biopsies, S-MRIs, Color Dopplers;
avoiding aggressive treatment (on light TIP--Avodart only for both my
benign prostatic hyperplasia and PCa); writing my PCa story ( prostate-
cancer-story.net ).

Lawrence J. Bookbinder, Ph.D.
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2 2nd June 00:33
george conklin
External User
 
Posts: 1
Default review of: Invasion of the Prostate Snatchers (cryotherapy bladder hyperplasia cancer ultrasound)


Prostate Snatchers, published in August of 2010, is the best book I
know of to help newly diagnosed men decide what to do about their
prostate cancer (PCa). Co-written by one of the best medical
oncologists specializing in PCa (MOSPC) in the USA, it’s filled to the
brim with gems of cutting-edge, authoritative information. Below are
some of these gems, which, unfortunately, only a small minority of PCa
patients have seen:

There is not one but three basic categories of PCa--Low-Risk,
Intermediate-Risk, and High-Risk.

High-Risk, also known as “aggressive,” should be treated aggressively
whereas Low-Risk often can be safely managed with no treatment.

A typical scenario after a primary care doctor refers a patient to a
urologist because of an abnormal PSA test and/or digital rectal
examination (DRE): The urologist biopsies the patient's prostate and
finds PCa. The patient views this finding as a death sentence, panics,
and feels pressured to get rid of his cancer immediately. He avoids
taking time for second opinions and agrees quickly to have the
urologist cut out his entire prostate (radical prostatectomy or RP)--
an aggressive treatment.

Unfortunately, of the 50,000 RPs done in the USA every year, more than
40,000 were not necessary. That is, the vast majority of PCa patients
would have lived as long without having their prostates removed.

RP is no longer the most effective treatment for PCa. Radiation
therapy (RT), another aggressive treatment, has evolved into being at
least as effective. If the patient consults a radiation therapist for
help with making a treatment decision, the doctor is often, of course,
biased in favor of recommending RT.

A third type of PCa doctor is a medical oncologist. They are trained
to treat all types of cancer--lung, blood, bladder, pancreas, etc,
Their training in PCa treatment only focuses on advanced disease.
Early-stage disease is left to the urologists.

Medical oncologists treat some PCa patients with testosterone
inactivating pharmaceuticals (TIP, also known as “hormone blockade” or
“androgen deprivation therapy”). TIP has its own set of side effects
but, unlike RP, RT, or cryotherapy, the side effects are often
reversible when the medical oncologist discontinues the TIP. And he
then, depending on the PCa’s response to the discontinuation, may re-
start the TIP a year or two or three later.

Unfortunately, only a minority of urologists are as skilled as MOSPCs
in providing TIP.

Of the more than 10,000 medical oncologists in the USA only less
than 100 are MOSPCs.

MOSPCs often do a more comprehensive evaluation of PCa than some
urologists. In addition to PSA tests, DREs, PSA velocity calculations,
and PSA density calculations, they may use spectrographic endorectal
MRI (S-MRI) scans, color doppler ultrasound scans, and PCA-3 urine
tests to determine whether a patient is Low-, Intermediate-, or High-
Risk. These tests also help monitor a patient’s PCa (known as “active
surveillance” or AS).

The comprehensive evaluation helps to determine whether the patient
should have an immediate initial biopsy. If the patient has had a
biopsy, the evaluation may reduce the number of repeat biopsies needed
for AS.

Typically, a MOSPC will offer the Low-Risk patient the option of no
treatment but with AS. If the patient rejects this option because he
wants to kill his PCa, the MOSPC will mention the advantages and
disadvantages of aggressive treatments such as RP, RT, and
cryotherapy, and with less bias than most urologists, radiation
therapists, and cryotherapists, respectively.

Chapters written by Ralph H. Blum, a patient of his co-author, vividly
illustrate the struggles of and benefits received by a patient who
educates himself about PCa, finds the right doctor for him, and avoids
blindly following his and other PCa doctors’ advice. Blum’s knowledge
and story of his 20-year PCa journey is likely to calm many patients,
instill hope, and empower them to play an active role in their
journey.

Blum traveled from the USA to Holland to have a recommended Combidex
MRI because it was the only place in the world that performed the
scan. My guess is that no more than 10 percent of PCa patients are
able to take the time off and/or pay for out-of-state/country trips
for tests or second opinions. I wish the book would have acknowledged
this unfortunate obstacle to obtaining state-of-the-art help.

Snatchers adds much to the meager literature on the role of the MOSPC
in working with Low-Risk patients and helping patients decide on a
treatment.

The preliminary international list of MOSPCs might help some patients
find the “right doctor.” Also helpful are a glossary, annotated
bibliography, and lists of acronyms and websites.

Snatchers replaces my former #1 choice, A Primer on Prostate Cancer:
The Empowered Patient’s Guide (2nd edition, 2005) by Stephen B. Strum,
M.D. (a distinguished MOSPC) and Donna L. Pogliano. Snatchers is
easier to read and understand; more up-to-date, of course; and
destined to become a classic, which is the status of Primer.

My qualifications for writing this review are 10 years of reading
authoritative PCa literature; participating in PCa internet discussion
forums; leading PCa support group discussions; seeing the MOSPC co-
author of Snatchers every three months for nine years; consulting
other PCa doctors; undergoing biopsies, S-MRIs, Color Dopplers;
avoiding aggressive treatment (on light TIP--Avodart only for both my
benign prostatic hyperplasia and PCa); writing my PCa story ( prostate-
cancer-story.net ).

Lawrence J. Bookbinder, Ph.D.

---

Well, given the results published in the New England Journal of Medicine
from the USA, treatment overall results in a higher death rate than nothing
at all.
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